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Children can be affected by two kinds of diabetes

Luis Fábregas
| Wednesday, Sept. 10, 2003

PITTSBURGH - The two known forms of diabetes can affect children at the same time, according to researchers at Children's Hospital of Pittsburgh.

Doctors call the condition "double diabetes," and they warn parents it could be triggered by obesity and lack of exercise.

"Parents do not think their children are overweight, and that can be a major factor in the development of diabetes," said Dr. Dorothy Becker, Children's chief of endocrinology and diabetes.

It is the first time doctors here have encountered the condition in children. It has been documented in adults and given other names such as diabetes-and-a-half. Children's doctors say it is considered more serious because it requires more aggressive treatment and can lead to life-threatening complications at an earlier age.

"Our fear is that, if not corrected, cardiovascular complications could occur earlier," Becker said. Her research, conducted along with Dr. Ingrid Libman, is being reported in the October issue of Diabetes Care, a publication of the American Diabetes Association.

If untreated, both forms of diabetes can lead to nerve damage, blindness, strokes and heart attacks, said Dr. Alejandro Gonzalez of West Penn Hospital's Joslin Diabetes Center.

Gonzalez, who has treated some adults with double diabetes, said diabetes is serious no matter the type or how it presents itself. Both types involve problems with insulin, the hormone that helps cells convert blood sugar into energy.

"The treatment tends to be the same, to normalize the blood sugar however you want to do it," he said. "The potential for developing complications is dependent on the duration of diabetes rather than the type."

The study of 260 children by Becker and her colleagues found that out of the group one in four black children and one in 10 white children had double diabetes. That means they had classic symptoms of both: insulin-dependency, the hallmark of type 1; and insulin-resistance, the hallmark of type 2. In type 1 diabetes, insulin-secreting cells in the pancreas die off and force people to inject daily insulin; in type 2, cells gradually become resistant to insulin.

Between 1979 and 1988, children found to have the condition had been initially diagnosed with type 1. Becker said 25 percent of black children and 10 percent of white children were obese and had a skin condition that is typical of those with type 2 diabetes.

Type 2 diabetes is far more common than type 1, afflicting 15 million Americans. Less than 2 million people suffer from type 1. Both conditions can be inherited. Doctors believe type 2 is more prevalent because of its link to obesity. Public health officials say about 13 percent of the nation's children are overweight.

More studies are planned to determine the best course of treatment for these children.

Becker said the message to parents is clear: All children should be checked by pediatricians to determine whether their body mass index is consistent with their growth.

"They should exercise them and feed them adequately," she said. "Don't let them get overweight."

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